Provider Demographics
NPI:1477592111
Name:RUBINSTEIN, WENDY S (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:S
Last Name:RUBINSTEIN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CENTRAL ST
Mailing Address - Street 2:SUITE 620
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1777
Mailing Address - Country:US
Mailing Address - Phone:847-570-1029
Mailing Address - Fax:847-733-5318
Practice Address - Street 1:1000 CENTRAL ST
Practice Address - Street 2:SUITE 620
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1777
Practice Address - Country:US
Practice Address - Phone:847-570-1029
Practice Address - Fax:847-733-5318
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X, 207SG0201X, 207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Not Answered207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF19963Medicare UPIN